Epidemic curves showing three
clusters of cases ofsevere acute respiratory syndrome (SARS) during the outbreak
atthe emergency room of the National Taiwan University Hospital.The first
two clusters (open bars) consisted of patients, familymembers, and nursing aids. The third
cluster (solid bars) consistedentirely of healthcare workers.31 cases of SARS occurred after
exposure in the emergency room at NTUH. The index patient was linked to an outbreak at a
nearby municipal hospital. Three
clusters were identified over a 3-week period. The first cluster (5
patients) and the second cluster (14 patients) occurred among patients, family members,
and nursing aids. The third cluster (12 patients) occurred exclusively among healthcare
workers. Six healthcare workers had close contact with SARS patients. Six
others, with different working patterns, indicated that they did not have
contact with a SARS patient. Environmental surveys found 9 of 119 samples of
inanimate objects to be positive for SARS coronavirus RNA. These
observations indicate that although transmission by direct contact with known SARS
patients was responsible for most cases, environmental contamination with the SARS
coronavirus may have lead to infection among healthcare workers without documented contact
with known hospitalized SARS patients.SARS virus is stable in the environment at
room temperature for 1~2 days. It can survive on plastic surfaces, stainless steel, glass
slides and paper files.The virus can survive even longer (up to 4 days) in
stool from
patients with diarrhea.Diarrhea is a common presenting complaint in SARS. One
of our patients
(Case 2 in the first cluster) presented with intestinal bleeding, and 4
patients in the second cluster had diarrhea.Overcrowding in the ER during an epidemic
augments opportunities for cross transmission and environmental contamination.In
addition overloaded medical staff may breach preventive procedures and take inadequate precautions.Environmental
contamination and SARS outbreak in the ER環境污染與急診群突發
SARS疫情期間，工作人員在醫療區域全程配戴N-95口罩仍感染SARS，環境微生物採檢
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